Manish Tripathi
Acute Osteomyelitis (AO) caused by haematogenous spread, accounts for 20% of osteomyelitis in adults. There are no reports of AO in renal transplant recipients. We describe AO in a 42-year-old renal allograft recipient, 7 years after the second transplant on triple immunosuppression with prednisolone, cyclosporine, and azathioprine. He presented to us with high-grade fever and weight loss for a month and was being treated for malaria and urinary tract infection. He complained of severe pain and swelling in his right leg, raising the clinical suspicion of osteomyelitis. This was confirmed by a radiological finding of a lytic lesion on the upper end of the right tibia, with cultures of E.coli both from pus aspirate from the bone and blood. We have reviewed the clinical features and radiological manifestations of AO with an emphasis on immunocompromised patients.